[Thoracoscopic resection of mediastinal parathyroid adenoma with cyst and hyperparathyroidism--a case report].
A 51-year-old woman was admitted because of general fatigue assumed to be due to climacteric disturbance. Laboratory examinations suggested a diagnosis of hyperparathyroidism based on high serum levels of Ca, intact PTH, and high-sensitivity PTH. No abnormalities were found in the cervix. Chest X-ray films and CT scans showed a mass measuring 4 cm in the right postero-upper mediastinum. The tumor was positive on a parathyroid scintigram, and was diagnosed as a mediastinal parathyroid adenoma with hyperparathyroidism. Operative findings showed a tumor surrounded by the superior vena cava, vagus nerve, azygos vein, and brachiocephalic artery. Careful resection of the hypervascular tumor from surrounding tissues was performed using a thoracoscopic technique alone. The postoperative course was uneventful. Serum values of Ca, intact PTH, and high-sensitivity PTH decreased to within normal ranges. after surgery. Pathohistological study confirmed the diagnosis of parathyroid adenoma including a cyst caused by degeneration of the tumor.
Shimizu
M
M
Department of Cardiothoracic Surgery, Tokyo Medical and Dental University, Japan.
Akamatsu
H
H
Yoshizaki
T
T
Tanaka
H
H
Sakamoto
T
T
Sunamori
M
M
D000236:Adenoma / Q000473:pathology / Q000601:surgery*; D003560:Cysts / Q000473:pathology / Q000601:surgery*; D004724:Endoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D006961:Hyperparathyroidism / Q000150:complications*; D008875:Middle Aged; D010282:Parathyroid Neoplasms / Q000473:pathology / Q000601:surgery*; D013906:Thoracoscopy